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BO QUOC PHONG
cue KHOA
HOC,
CONG NGHE VA MOI TRUING
BAO CAO TONG HOP
DE TAI DTDL.2007G/52
XAY DlTNG
CHINH
SACH BAO VE SlTC KHOE CHO QUAN
NHAN DONG QUAN TAI CAC VUNG 6 NHIEM CHAT DOC
HOA HOC/DIOXIN
Chu nhiem de tai: Dai ta, PGS.TS Hoang Van
Luong
Cu quan chu tri: Hoc vien Quan y, Bo Quoc phdng
Ha Ndi - 2010
16 I
%
jl04$
BANG
CHtr
VIET TAT

TS Tran Van Minh -
Cue
phd
Cue
Chinh sach.
2.
Ths. Tran Qudc Diing - Trudng phdng khoa hoc -
Cue
chinh sach.
3.
TS. Vu Thanh Thao -
Cue KJioa
hoc cdng nghe va Mdi trudng.
4.
Tran
Due
Hoan - Nguyen
Cue
phd Cue bao
trg
xa hoi -
BLDTB&XH.
5.
TS. Nguyin Hai Him - BLDTB&XH.
6. TS. Le Nam Cung -
Chii
Nhiem Chinh tri - Hoc vien Quan y.
7.
TS. Nguyen Duy Bac - Giang vien Hoc vien Quan y.
8. Ths. Nguyen Van Ba - Giang vien Hoc vien Quan y.

CDDC/Dioxin va ung thu 10
1.2.5.
Danh gia tac hai lau dai cua CDDC/Dioxin tren
sue
khoe eon ngudi
12
1.3. Mgt sd nghien cuu ve anh hudng cua Dioxin den
sue
khde con ngudi 13
2.
Muc do
6
nhiem va
Snh
hudng CDHH/Dioxin den moi trudng d cac
viing
ndng 17
3.
Mot so chu trucmg va chinh sach cua Nha
nude
19
5.i.
Tong quan vi
ddi
tirong chiu hau CBHH/Dioxin
& Viet
nam
19
3.2. Mot so chinh sdch da cd
ciia

3.3.7. Nghi dinh 67 /2007/ND-CP (13/4/2007)
ciia
Chinh
phii
36
3.3.8. Nghi dinh
105/2008/ND-CP
(16/9/2008) cua Chinh
phii
37
3.3.9. Danh gia tdng quat ve chinh sach ddi vdi ngudi bi hau qua chat doc
hoa
hoc 38
3.4. Thuc trang chl do, chinh sach cua quan nhan sdng lau dai d
vimg
hoa 40
hgc/Dioxin va nguyen nhan.
3.4.1.
Thuc trang chl dg, chinh sach ddi vdi nan nhan CDHH/dioxin noi
chung; mdi quan he vdi quan nhan dong quan lau dai d viing d nhidm
chit
do hoa hgc/Dioxin 40
3.4.2. Che do, chinh sach ddi vdi quan nhan sdng lau dai d viing d nhiem
CDHH/dioxin 42
Chuong 2. DOI
TUQfNG
VA PHlTONG PHAP NGHIEN
ClTU
49
2.1.

Han che cua de tai 55
2.6.
Van de dao
due
trong nghien cuu 55
Chuang
3.
KET QUA VA BAN LUAN 56
PHAN 1.
THlTC
TRANG
SLTC
KHOE QUAN NHAN DANG SONG
TAI CAC DIEM NONG 56
1.1. Nhimg thdng tin chung ve ddi tugng 56
1.2. Thuc trang ve hudng che do, chinh sach cua quan nhan tai 3 diem
ndng 58
1.3.
Thuc trang phai nhidm vdi CDHH/Dioxin cua quan nhan
59
1.4.
Thuc trang bdnh tat,
sue
khde cua quan nhan sdng viing ndng
61
1.4.1.
Tinh hmh benh tat chung qua kham bdnh
61
1.4.2.
Bieu hien benh ly qua chi sd mach, huylt ap va dien tam dd 65

2.2.
Nghien cuu cua de tai Z123 73
2.3.
Nghien cuu cua de tai doc lap cap Nha
nude
2002-2005 85
2.3.1.
Benh lidn quan vdi CDDC/Dioxin 85
2.3.2. Di dang bam sinh 85
2.3.3.
Bat thudng thai san 86
2.3.4. Tac hai
ciia
CDDC/Dioxin qua nghien cuu benh chung tai 3 bdnh
vien quan y: 108, 103 va 175 86
2.3.5.
Bien ddi cau tnic va chuc nang mdt sd gen 86
2.4.
Nghien cuu cua de tai doc lap cap nha
nude
87
PHAN
IIL
MU'C DO TON LUtJ CUA CDHH/DIOXIN TRONG MOI
TRU'OTNG
94
3.1.
Nong do Dioxin trong dat tai 3 diem ndng 94
3.2.
Nong do Dioxin trong mau

Chd do hau phuang
126
4.3.
Mot so bien phap bao ve sue khde, ngan ngira tiep xuc 134
4.3.1.
Chl do kham
sue
khde dinh ky
134
4.3.2.
Chl do su dung thirc pham chiic nang, tang cudng mien dich, tang thai
ddc 138
4.3.3.
Cac bien phap phdng tranh
phii
hgp bao vd
siic
khoe cho quan nhan
ddng quan tai cac viing d nhidm CDHH/Dioxin
13
8
4.3.4. Chinh sach vl chl do an cho quan nhan ddng quan tai cac viing d
nhiem CDHH/Dioxm 141
4.3.5.
Che do an dilu duang cho quan nhan ddng quan tai cac vimg d
nhidm CDHH/Dioxin
142
KET
LUAN 143
KIEN

lau dai
ciia
nd ddi vdi thien nhien va
con ngudi, td chirc tai Ha Ngi tir ngay
15 din
ngay
18
thang
11
nam 1993, da
dua ra ket luan: Chat dgc diet cd
ciia
My da gay ra nhiing tac hai nhu sau:
- Huy diet thidn nhien cay cd.
- Huy diet
siic
khoe con ngudi, gay nhidu bdnh tat nang ne.
- Gay nen nhung bidn ddi ve gen di truyen qua me hoac bd, gay
tai bidn
sirih san, quai thai, di dang, di tat
ciia
nhiing dira con sinh ra.
- Gay cac benh ung thu.
Lugng
CDHH/Dioxm
ma quan ddi My rai xudng mien Nam
Viet
Nam
dugc dua ra khac nhau, bdi cac tac gia khac nhau, trong dd thap nhat la theo sd
lieu

diet cd, lam trui la cay
ddi vdi con ngudi. Tilp theo dd, Uy ban 10/80 dudi su chi dao
ciia
GS Hoang
Dinh
Clu
da tap hgp cac nha nghien
ciiu
trong va ngoai nganh y tl, ca quan va
dan y giai quydt nhimg
vin
dd nghien cim dp bach
nhim
dua ra
nhung
giai
phap han che tac hai
ciia
CDHH/Dioxin ddi vdi cac nan nhan bi nhidm
CDHH/Dioxin. Tuy nhien, nhimg nghien
ciiu
trdn ciing nhu ddi tugng ap dung
la chi la
cim
chiln binh, ngudi cd cdng vdi each mang da nghi huu, con chau
cua nhiing nan nhan bj anh hudng CDHH/Dioxin bi di tat, nhung chua cd mdt
nghidn
ciiu
nao trdn ddi tugng can bd sy quan sdng lau dai tai viing nong, va
chua cd de tai nao chuyen sau vl xay dung chinh sach bao vd

nhiing chinh sach, chd do cd tinh chat dai ngd nhu thd nao nham hd trg cho cac
A
\ f
r
t
y.
ddi tugng ndi trdn la mgt
vide
lam can thidt cua cac cap cd tham quyen. Day la
mgt
vide
lam vira can thilt, vira the hien tinh nhan van cao ca, trong nhiing didu
r
kien thuc te cua chiing ta hien nay.
2.
Muc tieu de tai:
- Ddnh gid thuc trang
sue
khoe
ciia
qudn nhdn song tai viing nong 6
nhiem
b&i
chdt doc hoa
hoc/dioxin.
- De xudt chinh sdch,
bien
phdp bdo ve
site
khoe cho qudn nhdn dang

PeCDD. Vi vay to
chirc Y td thd gidi da xac dinh he sd duang lugng ddc td ggi la WHO - TEF dh
tinh gia tri dgc tdng hgp cho ca hg PCDD, PCDF va PCB doi vdi cac ddi tugng
mdi trudng, trong dd cd 2,3,7,8 - TCDD va
1,2,3,7,8
- PeCDD la nhimg
chit
ddc nhat cd he sd 1, va trong cac dong phan ddc
ciia
PCDD he so nay nhd
din
cho
din
0,0001 ddi vdi OCDD.
Dioxin cd tac dung ddc
tiic
thdi va lau dai, trong dd tac ddng lau dai la
dang chu y
nhit.
Lilu chdt 50 % (LD50) cua 2,3,7,8 - TCDD ddi vdi khi la 70
ppb vugt phan ldn cac chat ddc quan
sir
thudng trang bi
ciia
quan ddi cac
nude
nhu sarin, tabun, yperit Qua tinh toan lilu lugng tmng binh cd thd lam
chit
ngudi trong mdt lln tidp xiic qua dudng an udng la 0,05 - 0,07 ppm. Nhung dilu
quan trgng la tac ddng tich liiy va keo dai trong nhidu nam

ciiu
gan day lai ggi y rang: phai nhidm vdi TCDD cd anh
hudng manh
nhit
tdi he thdng mien dich, sinh san va he than kinh.
Rat nhidu nghien
ciiu
dua ra cac lieu gay chet sau khi phai nhidm CDD
tren ddng vat. Gia tri LD50 cho mdi loai chat cimg loai khdng chi thay ddi gitta
cac loai ma cdn thay ddi giiia cac chiing khac nhau.
Gia tri LD50 trdn chugt cdng Sherman sau diing lilu duy
nhit
dudng udng
2,3,7,8 - TCDD dugc tinh toan la
22|ig/kg (due)
va 45
|ag/kg
(cai); va lln lugt
la 164
^ig/kg,
297
|ag/kg,
303
|ag/kg
trdn chugt cdng Fischer 344; 165
ng/kg
(due) va 125
|ag/kg
(cai) d chugt cdng Osborne - Mendel; 43
^g/kg

|^g/kg hoSc
5.051
p.g/kg
d chugt
dit
Syrian. Mdt LD50 42 ngay d chugt lang Harley cai dugc xac dinh la 2,5
|ig/kg
khi trdn 2,3,7,8 - TCDD trong
diu
thuc vat va 19
|ig/kg
khi trdn 2,3,7,8 -
TCDD trong methyl cellulose.
Tang ty
Id tii
vong d chugt lang Harley khi bi phai nhidm vdi 0,03
|a,g/kg/ngay
2,3,7,8 - TCDD trong thiic an trong
11
ngay va d thd dang trong thdi
ky mang
thai
sau dimg 10 lidu hang ngay 1
|ig/kg
trong chd do an. Ngoai ra, 3
trong sd 12 khi rhesus dang mang thai chdt sau dung lidu duy nhat
l|ig/kg.
Trong
tit
ca cac nghidn

bing
nudi qua dng thdng da day da chdt trong
mdt nghien ciru 10 tuan; thdi gian tmng binh dan ddn chdt la 53,5 ngay. Tir vong
tang ciing
thiy
d chugt lang Harley phai nhidm hang ngay trong thiic an vdi lidu
0,03
|ig/kg/ngay
trong 60 ngay; 4 trong sd
10
chugt due chdt vao ngay thir 42
va 4 trong sd chugt cai chet vao ngay
thii
59. Trong nghidn
ciiu
sir dung thiic an
phai nhidm,
tit
ca cac chugt cdng Sprague - Dawley
due
dung thiic an lilu cao
4
nhit
(3,4
|ag/kg/ngay)
da
chit
trong vdng 4
tuin.
Chugt

vong d chugt
nhit
Swiss nhan 2,3,7,8 - TCDD qua dng thdng da
day vdi lilu 1,0
|ag/kg/ngay
va chugt
nhit B6C3F1
vdi lilu 0,36
|ig/kg/ngay.
Tu vong tang xuat hien sau khi phai nhidm cap tinh vdi cac chat CDD
khac.
Sau dung lilu don dudng
mi?ng
hon hgp
1,2,3,7,8,9
- HxCDD va
1.2.3.6.7.8
- HxCDD, gia tri LD50 dugc tinh toan lln lugt la 1.800
|ig/kg
va
800
|ig/kg
d chugt cdng Osbome - Mendel
due
va cai, va lan lugt la
750|j.g/kg
va 500
|ig/kg
d chugt
nhit

- HxCDD va 337,5
|ig/kg
vdi
1,2,3,7,8
- PCDD) sau dimg lidu dan dudng mieng bang nudi qua dng thdng
trong
diu
an.
6
chugt cdng Sprague - Dawley due, gia tri LD50 dudng mieng
ddi vdi
1,2,3,4,7,8
- PCDD,
1,2,3,4,7,8
- HxCDD va
1,2,3,4,6,7,8
- HpCDD
trdn
lln
trong
diu
thuc vat/acetone (95/5) lln lugt la 206, 887, 6.325
jig/kg.
Cac
ddng phan CDD khac cd ddc tinh
thip
hon, vi khdng
thiy
tac dung trdn
tii

ddc
nhit
trong sd
tit
ca cac
chit
ciing loai dugc
thii
nghiem, vdi lidu lugng chi
5
khoang vai
(ig/kg
trpng lupng co
thi
d
cac
thvc nghiem cip tinh da
din din til
vong cho tat
c4
cac loai dvpc thir nghiem.
Nguoc
lai, trong cac chit cimg loai
duoc
thil
nghigm, 2,7
-
DCDD
va
OCDD lai

djtih.
Ddng vat phai nhilm vdi 2,3,7,8 - TCDD theo dudng
udng
giam kha
nang sinh san, mat qua trinh
trade va
sau lam td cua trimg vao nigm mac
til
cung, giam trpng lupng bp phan sinh dvc, giam ndng dp androgen,
va
thay ddi
chu ky dpng due
va ning
tning. Hien tupng mit qua trinh trudc va sau lam td
cua trimg vao niem mac tu cung tang cao gap d chudt
edng
CRCD diing ligu 0,5
Hg/kg/ngay
trpng 2 tuan trade khi giao
phdi.
Tang tigu buy phdi thai gap d chudt
edng Sprague - Dawley dimg lilu 0,125
pg/kg/ngay,
d chupt nhit CF -1 dimg
ligu 1,0
ng/kg/ngay,
va chudt nhit
NMRI
dimg lilu 9
pg/kg/ngay

sd lupng tning giai phdng gap d
chudt
edng
Sprague - Dawley
cai
nhan lieu duy nhat > 10
pg/kg
theo dudng
udng. Tac dvng tren ndng do
hocmpn
ciing thay d chudt edng. Trong vdng 24
gid sau khi dua lilu hoa chit
vao,
ndng dp LH
va
FSH tang cap cd y nghia, ndng
dp prplactin khdng thay ddi. Sau khi dimg 17
(5
- estradiol, LH
va
FSH giam
thap
hem
so vdi chiing.
2,3,7,8 - TCDD ciing
la
mdt chit dpc trgn sinh san cua ddng vat due.
Giam trpng lupng bpng tinh djch gap d chudt
edng
Sprague - Dawley sau khi

0,00012
jig/kg/ngay
thi khdng
thiy
anh
hudng ddn qua trinh sinh
s^.
1.2. Tac hai cua CDHH/Dioxin tren ngudi
1.2.1.
Tdc hgi ciia CBHH/Bioxin
v&i sire khoe
sinh sdn:
- O
nam
gi&i:
anh hudng ldn su sinh tinh,
svr
di ddng cua tinh triing, hinh
lang
ciia
tinh trimg, ndng
dQ ciia
cac hormon quan trgng nhu gonadotropin, LH,
i^SH,
testosteron va eac androgen khac, ca quan dap
iing
vdi androgen, hanh vi
inh due va kha nang sinh san
liic
tmdng thanh. Nhidm Dioxin cdn cd

tidp phai
ihidm
vdi
chit
dgc hoa hgc trong chiln tranh, nay sdng d midn Bac Viet Nam,
Jidi
lugng
tuih dich/lln
xuat tinh giam, pH cua tinh dich tang so vdi qui udc
[udc td, tuy nhien nhimg biln ddi nay khdng
thiy
cd anh hudng ddn chiic nang
inh san.
*
Nhui
chung,
hiu hit
cac
mlu
tinh dich dugc nghien
ciiu
ddu dat tidu
huin
bmh thudng theo qui udc, nhung sd ngudi cd mat do tinh triing <
20.10^
d
ihdm
cd phai nhidm vdi AO/Dioxin nhilu hon so vdi nhdm khdng phai nhidm.
* Chi sd mat do tinh triing giam (<
20.10^)

ty
Id
sinh
t
IS,
r
con di tat bam sinh d nhdm cd nhidm chat da cam d xa Thanh Phong la 1,1% va
d phudng 10 quan Tan Binh thanh phd Hd Chi Minh la 5,4% cao ban nhdm
khdng nhilm
chit
da cam (0,4%) vdi p<0,05. Ty
Id
thai
chit
luu d nhdm cd
nhiem
chit
da cam la 0,8% va 0,34% cao hon nhdm khdng nhidm
chit
da cam
(0,02%) vdi
p<0,01.
Ty
Id
thai trirng d nhdm cd nhilm
chit
da cam la 0,73% va
3,74% cao hon nhdm khdng nhilm
chit
da cam (0,38%) vdi p<0,05. Ty

ca la chat ddc hoa hgc trong thdi gian chien tranh cho thay:
* Tai bidn
suih
san da xuat hien d thd he chau cac CCB chdng My, vdi tan
suat tang cao d nhdm cd tiep
xiic
so vdi nhdm khdng tidp
xiic,
sir
khac biet cd y
nghia thdng kd. Say thai: RR
=
9,02; CI, 3,65 - 22,26; p < 0,0001; RD =
24,8/10000; AFe
=
88,9%. Thai
chit
luu: RR = 8,56 ; CI. 2,05 -
35,81;
p <
0,001;
RD = 9,38/10000; AFe =
88,3%.
f f
F F
* Di tat bam sinh ciing xuat hien d the he chau cac CCB chdng My, vdi
nhiing
dac diem sau:
1).
Tin suit

diu
cd thd chua phat hien dugc mgt sd di tat kin dao khac, di tat he
thin
kinh nhu
cac dang thilu nang tri tue chilm vi tri cao
nhit
va tang cao hon d nhdm cuu
binh cd tidp
xiic,
lam ndn
sir
khac biet cd y nghTa thdng kd vdi p <
0,001.
Tilp
F
,
ddn la di tat ngoai hinh nhu cac bidn dang tay, chan ciing tang cao hon d
nhdm cd tilp xuc vdi y nghia thdng kd vdi p < 0,05.
4).
O nhdm cuu chidn binh cd tidp
xiic,
di tat
bim
sinh the he chau cd
gi&i
nam cao hon so vdi
nG,
vdi su can bang giira gidng ndi va gidng ngoai. Trong
khi d cac chau CCB A, DTBS gidi nir lai cao hon, vdi
sir

biet vdi cac di dang bam sinh do cac tac nhan khac:
Tdn sSxudt
hien cao bdt
thuang:
trong didu kien mdi tmdng va sinh sdng
>
F
•*
nhu nhau d trdn mdt cdng ddng, Dioxin la tac nhan gay ra mdt sd di dang bam
F
t
F
y
sinh cao hon sd di dang bam sinh do tat ca cac tac nhan khac khoang hai lan.
Tinh da di
dgng:
Trdn ca
thi ciia
mdt tre em cd nhilu di dang phdi hgp
theo nhidu hinh thiic khac nhau.
Cd thd cd mdt di dang (teo ca) lidn quan ddn nhidu bd phan khac nhau
ciia
ca thd.
Cd
thi
cd cd nhilu di dang khac nhau, mdi di dang lidn quan
din
mdt bd
phan ca the.
Tinh

v&i
Dioxin:
- Ung thu dudng hd hap
(Respiratory cancer){ung
thu thanh quan, ung
»
F
thu phdi, ung ihu khi phd quan).
- Ung thu tidn liet tuyen
(Prostate
cancer).
- Bdnh da u tuy ac tinh
{Multiple
Myeloma).
F
- Bdnh gai sdng che ddi
{Spina
Bifida)
- Bdnh Porphyria Cutanea Tarda (bdnh rdi loan chuydn hoa
Porphyrin, dac tnmg bdi
sir
tang do man cam vdi anh sang, xuat hien cac ndt
phdng trdn da va cac tdn thuang khac, cd tang ham lugng porphyrin trong gan,
trong nude tilu).
F \
- Rdi loan than kinh ngoai bidn.
- Bdnh dai dudng typ 2.
Ngoai ra, cdn mdt sd bdnh khac hien nay tuy ngudi ta chua du chiing
F F
7

Cd thd cd
sir
lidn quan
giiia
phai nhiem Dioxin
va tang ty
Id
rdi loan tam than kinh. Tuy nhidn su khac biet cdn chua ro trdn
phuong dien thdng ke. Ngoai ra, cdn cd thd cd mdt thdi gian
tiim
In tir khi phai
fs/
F F
y
nhidm den khi khdi phat ra cac trieu chiing rdi loan tam than kinh. Ngudi ta cdn
thiy,
cd thd Dioxin gay ra hien tugng lao hda sdm bd nao con ngudi, lam cac tl
bao
thin
kinh bi pha
hiiy
sdm. Schulte va cs. (My, 1996); Liou va cs. (Taiwan,
1997),
Seilder va cs. (CHLB
Diic,
1996) da tim
thiy
cd
sir
lien he giiia phai

cac CCB uc va da tim
thiy
cac rdi loan hd
hip
d nhung ngudi cd phai nhidm vdi
Dioxin (RR tir 1,6
din
4,1). Nhung nghidn ciru
gin
day cho
thiy
nhilu bdnh ciia
dudng hd hap, bao gdm ca nhidm triing cap va man, hen suyen, gian
phi
quan,
tran dich mang phdi cd lidn quan vdi nhiem CDHH/Dioxin
F
F
fs,
y
f
- Roi loan he thong mien
dich:
nhidu nghidn ciru cho thay cd
sir
tang bdnh
nhidm trimg d cac ddi tugng cd nhiem Dioxin, RR udc tinh
bing
2,8. Mdt nghidn
cim cua Ld Cao Dai, Nguyen Thj Nggc Phugng va CS. cung cho

nhom chimg. Tuy nhien, do ca chd bdnh sinh phiic tap, va chi khoang 50%
ngudi cd bdnh dai thao dudng la dugc
chin
doan ra, ndn dn cd thdm nghidn
F F F F
'itt
Ciiu
cd
loai
trir nhiing ydu td lidn quan ddn ca chd bdnh sinh dd cd thd khang
F
dinh mdi lien he nhan qua giiia Dioxin va bdnh nay.
- Roi loan chuyen hoa Lipid vd
Lipoprotein:
mdi chi tim thay tinh trang
tang triglycerid d trong phdng thi nghiem, tuy nhidn ciing cd nghidn
ciiu
bac bd
F \
y
van dd nay. Can cd nghidn
ciiu
thdm.
- Benh duang tieu hoa, ke cd nhiem doe gan: Cac nghidn ciru hien tai
chua chiing minh dugc mdi lidn he nhan qua giiia Dioxin va cac bdnh dudng
tidu hda, nhung cd thd cd tang men gan d nhiing ngudi bi nhidm Dioxin. Ty
Id tii
vong do cac bdnh dudng tidu hda tang d ngudi da bi nhidm Dioxin
15
nam vl

Dioxin va
cac
benh nay. Mdt sd nghign cim cd nhic
din
kha nang bj cao
huylt
ap,
suy tim, suy dpng mach vanh, tai
biln
mach mau nap d nhdm cd phai nhilm
vdi CDHH/Dioxin cao hon d nhdm khdng phai nhiim.
1.2.4.
CDHH/Dioxin
vd ung thu:
Cac nghign cim da chi ra Dioxin cd thg gay ra mpt sd
Ipai
ung thu sau:
Ung thu dudng hd hap
va
phdi
Ung
thu
tuygngiap
Ung thu phan mgm
Ung thu he Lympho tap huylt: Lympho khdng Hodgkin, benh
Hodgkin, da u hiy, bgnh bach cau
Ung thu he tigu hda nhu
gan,
tvy, da day,thuc quan, dai trang
Ung thu tign

tai bign smh san;
Chi sd thdng minh; Nhirng bign ddi di traygn va ung thu; Nhihig bign ddi vg
mau va
he men chuygn
hoa;
Nhttng bign doi
vg
he mien djch.
1.2.5.
Bdnh
gid
tdc
hai
lau ddi cda CDHH/Dioxin
trin
site
khoe
con
ngudi:
Nghien ciru dg dua ra nhimg kgt
luan
vl anh hudng
ciia
Dioxin ddi vdi
sure
khog con ngudi la mpt
van
dg khd, nd ddi hdi
nhung
thigt ke nghign cim

chat dpc hoa hpc cua My
da
sii
dvng d Viet
Nam:
" Ve anh huong cua chdt diet co
a
Viet Nam 1962
-
1971"
12
ciia Alvin
L. Young, ca quan nang lugng My;
"Md/
tru&ng
bi rdi chdt
rung Id
cdy
&
Viet
Nam vd khd ndng
nhiem
doc ddi
v&i
con
nguai''
ciia
Michael
Nev^on,
dai

trdn curu chiln binh
iic,
Han Qudc
diu
khdng cd
sir
khac biet giiia 2
nhdm cd va khdng phai nhidm (hg da khdng ndu rd rang thdi gian va phuang
thiic phai nhidm
ciia
cac cuu chiln binh nay nhu
thi
nao).
r
Mdt thuc td khach quan ma mgi ngudi phai thira nhan la cac nghidn
ciiu
^ Ft
vd anh hudng ciia CDHH/Dioxin ddi vdi con ngudi thi khdng the co thirc dia
nao cd day
dii
nhan chung, vat chimg cd gia tri khoa hgc va phap ly nhu d Viet
Nam, trdn chinh con ngudi Viet Nam - nhiing ngudi bi tidp
xiic
lau dai nhat, cd
T > T
fs,
F F
thd cd nhidu ca thd trong ciing mdt pha he phai nhidm
true
tidp hoac gian tidp

F t
-y
F F
anh da bao cao vd tinh trang dot bidn nhidm sac thd ca vd sd lugng va cau tnic
d
nhiing
ngudi bi nhidm
chit
ddc diet cay cd
ciia
My.
Nhan thiic dugc tac hai
ciia
chat ddc hoa hgc chidn tranh ddn
siic
khoe
con ngudi, ngay tir sau giai phdng mien Nam cac nha khoa hgc Viet Nam da tidn
F F
hanh cac nghidn
ciiu
danh gia tac hai cua chat ddc da cam ddi vdi
siic
khoe con
ngudi. Nam 1983, tai hdi thao qudc tl lln
thii nhit
tai Viet Nam, Bach Qudc
Tuyen da trinh bay bao cao vd hau qua di tmydn
ciia
chat diet cd, lam trui la cay
ddi vdi con ngudi. Tidp theo dd, Uy ban 10/80 dudi su chi dao cua GS Hoang

Nam.
Nam 1982, Nguyen Hung Phuc va Cung Binh Tmng da tiln hanh dl tai
"Nghidn ciru hau qua trdn ngudi ciia
chit
dgc hoa hgc do My rai d miln Nam
Viet Nam va khdi thao bidn phap
khic
phuc" (dl tai mang ma so 52.02.05.02),
ddi tugng nghien cim la ngudi bi rai true tidp chat ddc hoa hgc thudc huyen
Gidng Chdm, tinh Bdn Tre, vdi cac ndi dung chinh sau:
Danh gia
sir
tdn luu
ciia
cac chat dgc hoa hgc chiln tranh d mdt sd dia
t
\
didm thudc midn Nam Viet Nam.
-
Dieu
tra xac dinh ca cau bdnh tat
ciia
nhiing ngudi da bi nhidm ddc true
^
F F
/•
tiep
do chat dgc hoa hgc chidn tranh.
- Danh
gia

dudi 3 trieu, ty
Id
hdng cau ludi giam nhidu (cd 9,76% sd ngudi cd hdng du
ludi
dudi
10.000/mm3).
- Sinh hoa:
thiy sir
rdi loan hoat do enzyme SGOT va SGPT, giam ham
lugng albumin trdn dien di protein huylt thanh, tang
y
globulin, ed bidu hien
thuong va giam chirc nang td bao gan.
- Di tmydn va tai bidn sinh san: Didu tra 848 cap vg chdng
thiy tin
sd sly
thai la 12,20 ±
1,44%.
Dilu tra 3000 tre de sdng tmdc va sau khi bi rai
chit
ddc
thiy
tmdc khi rai sd tre di tat 0,14 ± 0,08%, sau khi
rai:
1,78 ± 0,35%.
14
Nam 1998, tai hdi thao qudc gia vl tac hai
ciia
CDHH/Dioxin, Tmng tam
Nhiet ddi Viet Nga da edng bd mdt sd

Id
ngudi bi suy nhugc than kinh cao.
- Bdnh tim mach:
17,99%
(so vdi nhdm chimg 4,94%).
Bdnh da lidu: 5,78% (so vdi nhom chimg 0,52%).
- Benh
thin
kinh:
12,63%
(nhom chimg 2,53%).
F
- Ty
Id
tai bien sinh san d nhdm nghidn
ciiu
cao hon so vdi nhdm chiing
(34,54%
so vdi 14,96%).
- Tai khu vuc nghidn
ciiu
cd xu hudng tang ddng lympho B
(CD
19) va
t
giam ddng lympho T
(CD3,
CD4,
CD
18) va ty

ham lugng men esteraza tang cao chiing td ca thd
dang bi nhidm ddc.
-
6
nhdm ngudi nghidn
ciiu
ty
Id
thilu mau cao: giam sd lugng hdng
^
X
F
t
\
cau, tang ty
Id
bach cau, trong dd tang td bao lympho, giam tidu cau. Ty
Id
nhidm HbsAg d
miic
tmng binh cao (20,7%).
- Cac chi sd thdng minh va tdc do phan xa d tre em: Ty
Id
cac ddi
mgng tir 6-12 tudi d nhdm nghidn cim cd thdi gian phan xa cam giac
thip
hon
^
F
t

dp Nha
nude,
dp Bd
da dugc nghiem thu. Cac thudc nay co tac dung giai dgc thdng qua ca chl chdng
cac gdc tu do.
Dac biet da lay mau, tidn hanh phan tich ham lugng Dioxin tren 12
mlu
md md, kdt qua thu dugc cd
11
mau duong tinh vdi ham lugng Dioxin tir
10
ppt- 200ppt. Day la bang chiing khach quan khoa hgc cd y nghTa giiip cho nhiing
hudng nghidn
ciiu
mdi.
F
y
t F
Kdt qua didu tra di tat bam sinh trdn 10 phudng, xa cua thanh phd Bidn
Hoa cho thay:
- Ty le
mic
di tat
bim
sinh: 0,913 ± 0,018/1000 dan.
- Ty
Id mic
di tat
bim
sinh: 2,19 ± 0,83/1000 tre de sdng

sinh: 5,38 ± 0,79/1000 tre de song.
r
F
- Ty
Id
bai nao chidm cao nhat: 34,2%.
- Ham lugng men Carboxyl- Esteraza d
miic
do cao va cd
sir
gidng nhau
F
t
giiia bd - con, me - con ngudi bi di tat bam sinh.
- Cd
sir
thay ddi clu tnic gen P53 va tang ty
Id
ngudi cd ham lugng
proteui P53 thip
va rat thap d nhdm nghidn
ciiu.
- Nhdm nghien cim cd ty
Id
mang
diu
In ung thu CEA va AFP cao hon
nhdm chiing.
- Hgc sinh thugc nhdm nghidn
ciiu

san bay
Phii
Cat - Binh Dinh cho thay:
>
t
- Ve di tat bam sinh: Nhom ngudi sinh ra sau nam 1975 tai nhiing viing
sat san bay Phu Cat cd ty
Id
di tat
bim
sinh la: 5,22 ±
0,31
tinh trdn 1000 tmdng
hgp de sdng, ty
Id
nay cao so vdi cac viing khdng bj rai
chit
ddc da cam. Trong
dd cao
nhit
la cac dj tat vl
thin
kinh tmng uong chidm 30% trong tong sd 24 ddi
tugng di tat
bim
smb.
- vl biln ddi gene P53: Nhdm doi tugng nghidn cim d
Phii
Cat cd bidu
hien thay ddi clu tnic gen P53 d 29,27% ddi mgng. Ham lugng Protein P53

Ngii
Hiep
(ddi chimg xa) va thap ban ca tmdng Nguydn Du - Da
Ning
(ddi chiing
gin).
Didu tra
siic
khoe trdn ddi tugng cuu chidn binh
thiy:
Ty
Id
di tat
bim
sinh, tai bien sinh san, ty
Id
bdnh lien quan d cuu chidn binh cd tiln
sii
tidp
xiic
F F
y
F
vdi chat ddc da cam cao ban so vdi
cim
chidn binh khdng cd tidn su tidp
xiic.
/
y F F
Dac biet nhung cuu chidn binh cd tidn

phuang tidn rai mat
dit
khac nhu xe ca gidi, binh phun va tau sdng. May bay
t F
true thang ciing dugc
sii
dung
dQ
rai chat diet cd tai nhiing khu vuc xac dinh.
Khoang 72 trieu lit
chit
diet cd da dugc
sii
dung d Nam Viet Nam. Tuy nhidn
17